Abortion fight clouds AIDS-fighting program’s future

Democrats’ efforts to reauthorize the President’s Emergency Plan for AIDS Relief are floundering in the face of GOP opposition.

A bid by Foreign Relations Chair Bob Menendez (D-N.J.) to amend the defense policy bill that’s on the Senate floor this week to reauthorize PEPFAR for five years failed when Republican members objected.

Meanwhile, House Republicans confirmed this week that they will not put forward any reauthorization of the $7.5 billion program that fights AIDS and HIV, the virus that causes it, in more than 50 developing countries in Africa, Asia, Latin America and Europe. PEPFAR’s current authorization expires this fall. Republicans say the Biden administration has “hijacked” it to fund groups that provide and counsel patients on abortion.

GOP lawmakers instead want to use a one-year patch tucked into their Foreign Operations spending bill that keeps the decades-old program operating and includes language restoring a Trump administration rule blocking funding to any groups that discuss or financially support other organizations that provide abortions.

The Biden administration, Democratic lawmakers, officials running PEPFAR and independent experts say there’s no evidence any program funds have ever gone to providing or promoting abortion.

Why it matters: PEPFAR can continue without reauthorization, so long as Congress appropriates funds for it.

But Democrats and Republicans who want to reauthorize the program — created by President George W. Bush and widely credited with saving millions of lives — say anything less than a five-year reauthorization of PEPFAR would signal to other countries that the U.S. commitment to fighting HIV and AIDS is weakening and leave the program more vulnerable to cuts in the future.

“We can’t reach our global goal of ending the HIV epidemic by 2030 through 1-year increments,” Menendez said.

What’s next? Menendez said he plans to push for a markup and floor vote of a stand-alone reauthorization bill when Congress returns in September. That bill would extend the program as-is.

“Not one period, not one comma should be changed,” he said. “There are few programs in the world that people can point to that are currently keeping over 20 million people alive. I’m not about to give up on that.”

The House GOP spending bill that carries a one-year PEPFAR extension faces an uncertain path amid Republican-on-Republican fights over spending levels and abortion-related riders.

Rep. Chris Smith (R-N.J.), who chairs the House Foreign Affairs Subcommittee on Global Health, Global Human Rights & International Organizations, told POLITICO that he and other conservatives are crossing their fingers that a one-year patch will carry the program until a new president more supportive of their desired anti-abortion language takes office.

“There is that hope,” he said. “But if we’re back with Biden, we’ll fight this just as hard, because the children are worth it.”